An adolescent client reports to the nurse of walking with a limp due to pain localized in the right knee which worsens at night but denies any recent injury or trauma. The nurse observes swelling and tenderness in the right lower thigh, and imaging results reveal radial ossification in the soft tissues.
Which condition should the nurse consider as the probable cause of the findings?
Osteosarcoma
Growing pains
Rhabdomyolysis
Hemosiderosis
The Correct Answer is A
The adolescent client's symptoms of localized pain, swelling, and tenderness, particularly at night, are suggestive of a malignancy such as osteosarcoma, which is the most common primary bone tumor in children and adolescents.
Radial ossification in the soft tissues is a characteristic finding in osteosarcoma and is indicative of bone production by malignant cells. Other imaging modalities, such as X-rays, computed tomography (CT), and magnetic resonance imaging (MRI), may also reveal osteolytic or osteoblastic lesions in the bone.
Growing pains are a common, benign condition that occur in children and do not typically present with the
symptoms described in the case scenario.
Rhabdomyolysis is a medical emergency that involves the breakdown of skeletal muscle tissue and release of muscle fiber contents into the bloodstream. It can present with muscle pain, swelling, and tenderness, but typically occurs as a result of injury, infection, or drug toxicity.
Hemosiderosis is a rare condition characterized by the accumulation of iron in various tissues, including the liver, spleen, and bone marrow. It may present with symptoms such as fatigue, joint pain, and abdominal pain, but is not typically associated with the symptoms and imaging findings described in the case scenario.
Therefore, the nurse should consider osteosarcoma as the probable cause of the adolescent client's symptoms and imaging findings, and should collaborate with the healthcare team to develop a plan of care for diagnosis and treatment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Answer: A
Rationale:
(A) Repair should be done before the child is potty-trained: Surgical correction of hypospadias is typically recommended before the child reaches the age of 18 months, ideally between 6 and 12 months. This timing ensures that the child has not yet developed any psychological awareness of the surgery and helps avoid complications during toilet training. Repair before potty training is important to prevent urinary dysfunction and psychosocial issues.
(B) The urethral repair should be done after sexual maturity: Delaying surgical repair until after sexual maturity is not recommended. Early repair is crucial to ensure normal urinary and sexual function, and delaying it could lead to complications such as difficulty with urination and psychological distress.
(C) Surgery should be done by one month to prevent bladder infections: While preventing urinary tract infections is important, performing surgery as early as one month is not typically necessary or recommended. The optimal timing is closer to 6 to 12 months of age when the child is more resilient to surgery but still before the developmental milestones of potty training.
(D) Delaying the repair until school age reduces castration fears: Delaying the surgery until school age can actually increase psychological stress and fear of castration. Early surgical correction is preferred to minimize psychological impact and to allow the child to develop normally without the need for complex explanations or fear of surgery later in life.
Correct Answer is D
Explanation
If a child's systolic blood pressure is greater than the 90th percentile during a routine clinic visit, the nurse should take the blood pressure two more times during the visit and determine the average of the three readings. This will provide a more accurate assessment of the child's blood pressure. Referring the child to the healthcare provider and scheduling an evaluation of blood pressure in two weeks
A. may be necessary if the child's blood pressure remains elevated, but it is not the next action that should be taken. Measuring the child's blood pressure three times during the visit and determining the highest of the readings
B. is not recommended because it may overestimate the child's blood pressure. Conducting a head-to-toe assessment and omitting repeated blood pressures during the examination
C. is not appropriate because it does not provide an accurate assessment of the child's blood pressure.
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